MRS. STACIE KETCHAM (NPI# 1144696865) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1144696865 |
| Entity Type | Individual |
| Full Name | MRS. STACIE KETCHAM |
| Credential | LPN |
| Practice Address |
9040 Reid St Attn:mchj-clq-c Joint Base Lewis Mcchord WA 98431-1100 |
| Practice Telephone | 2539682252 |
| Mailing Telephone | 2539682252 |
| Enumeration Date | 2015-08-17 |
| Last Update Date | 2015-08-17 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 164W00000X | Licensed Practical Nurse | LP 60538305 | WA | Nursing Service Providers |
| Street Address |
9040 REID ST ATTN:MCHJ-CLQ-C |
| City | JOINT BASE LEWIS MCCHORD |
| State | WA |
| Zip Code | 98431-1100 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1295187342 | Donald Vallier | Nurse Anesthetist, Certified Registered | 9040 Reid St, Joint Base Lewis Mcchord, WA 98431-1100 | 2016-07-12 |
| 1467808477 | Erica Lewis | Dietitian, Registered | 9040 Reid St, Joint Base Lewis Mcchord, WA 98431-1100 | 2016-05-09 |
| 1669835526 | Patricia Barre | Nurse's Aide | 9040 Reid St, Attn: Mchj-clq-c, Joint Base Lewis Mcchord, WA 98431-1000 | 2016-03-29 |
| 1497129019 | Nancy Vander Linden | Dietitian, Registered | 9040 Reid St, Joint Base Lewis Mcchord, WA 98431-1100 | 2015-11-19 |
| 1902279631 | Alicia Pabilona | Dietitian, Registered | 9040 Reid St, Attn: Mchj-clq-c, Joint Base Lewis Mcchord, WA 98431-1100 | 2015-11-03 |
| 1720455348 | Nicole Glojek | Registered Nurse | 9040 Reid St, Joint Base Lewis Mcchord, WA 98431-1100 | 2015-08-31 |
| 1578930749 | Madigan Army Medical Center | Clinic/Center | 9040 Reid St, Joint Base Lewis Mcchord, WA 98431-1100 | 2015-08-24 |
| 1457737314 | Cathy Crawford | Licensed Practical Nurse | 9040 Reid St, Joint Base Lewis Mcchord, WA 98431-1100 | 2015-08-03 |
| 1821473257 | Rowena V Marcelo | Registered Nurse | 9040 Reid St, Joint Base Lewis Mcchord, WA 98431-1100 | 2015-07-28 |
| 1750764510 | Marina Singian | Registered Nurse | 9040 Reid St, Joint Base Lewis Mcchord, WA 98431-3278 | 2015-06-29 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497212260 | Catrina Renee Grugin | Registered Nurse | Madigan Army Medical Center, Attn Mchj-clq-c, 9040 Jackson Ave, Tacoma, WA 98431 | 2019-02-27 |
| 1801307681 | Bianca Gomez | Dental Assistant | Bldg 9900 Lincoln Street, Jblm, WA 98431 | 2017-10-19 |
| 1184133225 | Darren Paris | Registered Nurse | Madigan Army Medical Center 9040 Jackson Ave., Attn: Mchj-clq-c, Tacoma, WA 98431 | 2017-09-20 |
| 1922538206 | Sarah Frerichs | Dentist | Madigan Annex, Second Floor, Bldg. 9900, Apo, AA 98431 | 2017-06-19 |
| 1740736495 | Misty Hill | Dental Assistant | 9119 Mill Park Ave, Tacoma, WA 98431 | 2016-08-31 |
| 1336695535 | Jacqueline D Massouda | Dentist | Jblm Dentac, 9900 Lincoln Sreet, 2nd Floor, Apo, AA 98431 | 2016-08-28 |
| 1609239375 | Gregg V Palmer | Licensed Practical Nurse | 17th and C Street, Bldg 11582, Tacoma, WA 98431 | 2016-03-31 |
| 1114323904 | Deanna Sheets | Nurse Practitioner | 911 Mil Park Ave, Tacoma, WA 98431 | 2014-11-06 |
| 1679905434 | Austin William Schaar | Dentist | Building 9900, 2nd Floor, Tacoma, WA 98431 | 2013-08-05 |
| 1518209758 | Maurice Ibrahim Khayat | Internal Medicine | 9040 Jackson Ave Mche-qd (creds), Tacoma, WA 98431 | 2013-03-26 |
| Find all providers in zip 98431 | ||||
| Taxonomy Code | 164W00000X |
| Grouping | Nursing Service Providers |
| Classification | Licensed Practical Nurse |
| An individual with post-high school vocational training and practical experience in the provision of nursing care at a level less than that required for certification as a Registered Nurse. Requirements for education, experience, licensure, and job responsibilities vary among the states. |
| Notes: Source: Rhea, Ott, and Shafritz, The Facts On File Dictionary of Health Care Management, New York: Facts On File Publications, 1988. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811203037 | Brian D Worley | Licensed Practical Nurse | Mamc 9040 Fitzsimmons Dr, Joint Base Lewis Mcchord, WA 98431-1100 | 2010-08-25 |
| 1275195877 | Michael C Saenz | Licensed Practical Nurse | 9040a Jackson Ave, Joint Base Lewis Mcchord, WA 98431-0001 | 2019-07-03 |
| 1154877645 | Chanel Pedersen | Licensed Practical Nurse | 690 Barnes Blvd, Joint Base Lewis Mcchord, WA 98438-1303 | 2016-08-25 |
| 1457737314 | Cathy Crawford | Licensed Practical Nurse | 9040 Reid St, Joint Base Lewis Mcchord, WA 98431-1100 | 2015-08-03 |
| 1598071789 | Quantrell L Felder | Licensed Practical Nurse | 9040 Fitzsimmons Dr, Joint Base Lewis Mcchord, WA 98431-1100 | 2010-08-25 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578163424 | Joseph Mbote | Licensed Practical Nurse | 1017 W 17th St, Port Angeles, WA 98363-7435 | 2020-10-29 |
| 1942808332 | Christine S Kruger | Licensed Practical Nurse | 103 E Main St Ste 304, Walla Walla, WA 99362-1900 | 2020-10-16 |
| 1346857422 | Robert Gitonga | Licensed Practical Nurse | 3206 94th St S, Lakewood, WA 98499-3553 | 2020-09-23 |
| 1366058869 | Ruth Wakarima Martineau | Licensed Practical Nurse | 2100 S 336th St, Federal Way, WA 98003-8961 | 2020-09-20 |
| 1275143570 | Hiljay Homes Inc | Licensed Practical Nurse | 111 Nw 203rd St, Shoreline, WA 98177-2019 | 2020-08-03 |
| 1437767050 | Kimberley Damian | Licensed Practical Nurse | 1902 E Kessler Blvd, Longview, WA 98632-1844 | 2020-07-20 |
| 1649897505 | Erin Day | Licensed Practical Nurse | 12101 Daphne Ln Nw Apt B108, Silverdale, WA 98383-8680 | 2020-06-26 |
| 1003432782 | Jayde M Wright | Licensed Practical Nurse | 638 12th St, Washougal, WA 98671-1309 | 2020-06-18 |
| 1225652597 | Caesar Mburu | Licensed Practical Nurse | 4607 Sw 327th St, Federal Way, WA 98023-1901 | 2020-06-03 |
| 1922629427 | Helen Kigonya Babirye I | Licensed Practical Nurse | 9625 Croft St S, Tacoma, WA 98444-6533 | 2020-05-06 |
| Find all providers with the same taxonomy | ||||
| City | JOINT BASE LEWIS MCCHORD |
| Zip Code | 98431 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.